NPIMap

Individual provider Active NPI

Samuel Theodore Shaikewitz, MD

  • Nephrology Physician
  • Durham, NC
National Provider Identifier
1447276381
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
9801487 Issued in NC
Practice address
4419 Ben Franklin Blvd
Durham, NC 27704-2147
Phone
(919) 477-3005
Fax
(919) 477-5526
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 9801487 NC Primary

Addresses

Primary practice location

4419 Ben Franklin Blvd
Durham, NC 27704-2147

Mailing address

4419 Ben Franklin Blvd
Durham, NC 27704-2147
Phone (919) 477-3005

Other identifiers 1

IdentifierTypeStateIssuer
7910478MedicaidNC

Other names 1

  • Dr. Ted Shaikewitz Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100416000169 NC Practitioner - NephrologyPractitioner - Internal Medicine 3971682410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Washington University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Durham Nephrology Associates PAGroup PAC ID 3072589027, 10 clinicians

Practice addresses (Care Compare)

4419 Ben Franklin Blvd
Durham, NC 27704-2147
Phone (919) 477-3005

Hospital & facility affiliations

  • FMC Dialysis Services of Briggs Avenue Dialysis facility, Durham, NC, CCN 342615
  • FMS Dialysis Services of Oxford Dialysis facility, Oxford, NC, CCN 342647
  • FMC-Eno River Dialysis facility, Durham, NC, CCN 342762
  • Duke Regional Hospital Hospital, Durham, NC, CCN 340155
  • Duke University Hospital Hospital, Durham, NC, CCN 340030
  • Granville Health Systems Hospital, Oxford, NC, CCN 340127

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9801487NCMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Durham Nephrology Associates PA Nephrology CurrentSince Oct 1, 1998 Accepting new patients

Locations

4419 Ben Franklin Blvd
Durham, NC 27704
Phone (919) 477-3005

102 Professional Park
Ste B
Oxford, NC 27565
Phone (919) 477-3005

Interoperability endpoints

  • Direct secure messaging: sshaikewitz15272@direct.acumenmd.com
  • Direct secure messaging: ted.shaikewitz@direct.dna.nchie.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1447276381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 BEN FRANKLIN BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042147",
            "telephone_number": "919-477-3005",
            "fax_number": "919-477-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 BEN FRANKLIN BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042147",
            "telephone_number": "919-477-3005",
            "fax_number": "919-477-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAIKEWITZ",
        "first_name": "SAMUEL",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2022-02-01",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NC",
            "license": "9801487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7910478",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TED",
            "last_name": "SHAIKEWITZ",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.